title: Glomerular volume and the glomerular vascular pole area in patients with insulin-dependent diabetes mellitus.
abstract: The vascular pole area (VPA) and glomerular volume were measured in renal biopsies from 9 insulin-dependent diabetes mellitus (IDDM) patients with normal albumin excretion rate (IDDM group 1), 38 IDDM patients with albumin excretion rate > 15 micrograms/min (IDDM group 2) and 10 living kidney donors (ND). The volume of individual glomeruli was estimated as the sum of profile areas factored by the measured distance between levels, t approximately 10 microns, and VPA as the sum of chords multiplied by t. Mean glomerular volume was increased in IDDM patients but reached statistical significance only in IDDM group 2 (P = 0.002 vs ND). VPA was significantly different among the groups, mean (CV%) was 2036 (29) microns2 in ND, 3555 (34) micron2 in IDDM group 1, and 3528 (48) microns2 in IDDM group 2, p = 0.004 and 0.001, IDDM versus ND. VPA calculated as a percentage of the surface area of the corresponding glomerulus was 2.4 (23)% in ND, 3.4 (27)% in IDDM group 1, and 3.3 (42)% in IDDM group 2; P = 0.007 and 0.01, IDDM versus ND. The intra-biopsy coefficient of variation was high (20-35%) and of the same order in all groups for all three measurements. Glomerular volume and absolute as well as relative size of VPA showed a positive correlation with estimates of mesangial expansion in IDDM group 2 and the VPA showed a negative correlation with GFR. Thus, part of the enlargement may represent a compensatory phenomenon triggered by the development of structural and functional abnormalities in the diabetic kidney.
authors.affiliation: Institute of Experimental Clinical Research, Aarhus Kommunehospital, Denmark.
authors.forename: R
authors.initials: R
authors.lastname: Osterby
authors.forename: J
authors.initials: J
authors.lastname: Asplund
authors.forename: H J
authors.initials: HJ
authors.lastname: Bangstad
authors.forename: G
authors.initials: G
authors.lastname: Nyberg
authors.forename: S
authors.initials: S
authors.lastname: Rudberg
authors.forename: G
authors.initials: G
authors.lastname: Viberti
authors.forename: J D
authors.initials: JD
authors.lastname: Walker
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000473:pathology*; D005260:Female; D006801:Humans; D006984:Hypertrophy; D007678:Kidney Glomerulus / Q000473:pathology*; D008297:Male; D008875:Middle Aged